Survivors of child maltreatment—physical, sexual, and emotional abuse; witnessing intimate partner violence; and neglect—experience poorer physical health compared with those who did not experience such maltreatment. For example, studies have shown that maltreatment survivors are at greater risk of developing disorders that are leading causes of death, such as heart disease, obesity, cancer, and inflammatory diseases (Brown et al., 2009; Clemens et al., 2018; Danese & Tan, 2014; Felitti et al., 1998; Gilbert et al., 2015). A few studies have also reported that adverse childhood experiences may correspond with fertility challenges (Harville & Boynton-Jarrett, 2013; Jacobs et al., 2015). Adverse childhood experiences is an umbrella term that pertains to only two of the child maltreatment types—sexual and physical abuse—but it also encompasses other nontraumatic events, such as parental mental illness. At this time, it is not clear whether survivors of childhood maltreatment are at greater risk of infertility problems than are those who have not been maltreated. Because maltreatment can consist of any one or more of five different types of abuse and neglect, it is important to include survivors of each maltreatment type in fertility studies, because there may be critical differences in the effect of each maltreatment form on fertility.
Maltreatment survivors are also at high risk of developing posttraumatic stress symptoms (PTSS), and PTSS may also be associated with decreases in fertility—for example, it may lengthen the time needed to conceive (Wamser-Nanney, 2020). Yet no study to date has investigated both maltreatment and PTSS at the same time.
These gaps in the literature are problematic, especially given that in 2019, birth rates in the United States fell to their lowest level in over three decades (Centers for Disease Control and Prevention, 2020; Chandra et al., 2013). Thus, infertility is a pressing public health concern.
A study recently publishedopens in new window in Psychological Trauma: Theory, Research, Practice, and Policy looked at the possible effects of different types of child maltreatment and PTSS on survivors’ fertility. The sample included 275 women who had experienced at least one traumatic event during their childhood and who had been or had tried to become pregnant. Among the variables examined in the study were the length of time it took participants to conceive, the number of live births and miscarriages, and the use of infertility testing and treatment. In comparison with other participants in the study, participants experiencing PTSS reported a lower number of live births. Survivors of neglect also reported a greater number of miscarriages and more use of fertility treatments. Surprisingly, none of the five types of maltreatment nor PTSS was related to needing a longer time to conceive. Trauma symptoms and neglect may be related to higher risk of fertility difficulties. But other forms of child maltreatment (sexual, physical, and emotional abuse and witnessing intimate partner violence) may not increase fertility challenges. Another key finding was that participants who were racial minorities disclosed that it took them a longer time to become pregnant, which is consistent with other research showing that women of color may be at greater risk of infertility and reproductive challenges.
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